Thursday, February 14, 2008

Dr. Steven Horvitz's practice transition

When I started my family medical practice in 1998, the majority of patient visits and hence the revenues that came into my office was for sick care. At the time, it was what my patients and the public were demanding and what I was glad to provide. But today, with the baby boomer generation getting older, and healthcare costs skyrocketing, demand has increased for medical programs to help patients stay well.

But physicians today are forced to practice under an outmoded system that rewards frequent, extensive and expensive medical care for the very sick, but does not reward for the teaching and teamwork that goes toward prevention of illness. The government in its wisdom, throws more and more money into this system which gets worse year by year. The tremendous amount of government regulations and insurance industry greed and profits has doomed our healthcare system. The present healthcare scenario will not survive as is. The government can not save it. The health insurance industry can not save it. Only patients and physicians first taking individual responsibility, and then forming a partnership in their medical care can.

In January 2008 I started my transition towards a practice that is more patient centered and patient focused. I terminated my contracts with all health insurers except Medicare. With this practice conversion, I am now able to:1. Improve access to medical care by offering same and next day appointments.2. Improve communication with patients through longer appointment times, easier telephone access, and internet communication via email and our new and improved website.3. Help patients to be better managers of their care via stronger coordination of the healthcare services they obtain outside my office. Many physicians are so busy seeing 30+ patients per day that they do not have the time for this coordination of medical care. In my new practice model, We Do!!

Thus far, I have been able to turn the healthcare system upside down, by engaging patients in this team concept of wellness and prevention. I tell all my patients, “ Put your effort into true health wellness and prevention, and I will treat your illnesses for a discount, without any health insurer or third party interference.” My patients who have teamed with me for their healthcare needs by enrolling in my wellness plans, get discounted fees, usually equal to or less than their insurance copay for all their sick care at my office. I am no longer restrained by health insurer contracts what I can offer and what I can advise. By terminating my relationships with the health insurers, I can again become my patients #1 advocate in their care.

One of the nicest comments I ever received was in 1991, from a fellow medical school student who happened to be a patient in my fathers family medical practice in Philadelphia. He told me the main reason he went to medical school was because of the personal connection and trust he and his family received in their medical care from my father while growing up. This trust shaped this students life and career aspirations. Do people still have this same sense of trust in their doctors today?

Sometimes moving forward is not the answer. Sometimes we need to look backwards, to a system that worked in the past. To a system where you picked your doctor based on quality and trust and not by looking at an insurance directory filled with names of physicians you do not know. My practice will move forward and grow by looking backwards. The basic qualities of the doctor-patient relationship will be emphasized again. My patients will choose my practice for the basic qualities of a true family physician such as expertise, sincerity, personal connections, and trust.

I look forward to 2008 and all the challenges that it brings. I value each and every individual in my practice and hope to continue to offer the best family medical care possible.

1 comment:

Dr. Horvitz: My family is contemplating a move to another state. How do we go about locating a family physician who shares your philosophy on the practice of medicine? Has a network of like-minded healthcare providers developed? If yes, how does one locate them - is there a central website?Jo B.